JPH0349491B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a body cavity pressure adjusting device for an endoscope, which is used in an endoscope to adjust the body cavity pressure during observation.

[Conventional technology]

Organs in body cavities, such as the stomach and intestines, generally have a self-contracting habit, so when examining the inside of a body cavity using an endoscope, air, etc., is sent in from the outside through the air supply pipe built into the endoscope. This pressure inflates the inner wall of the body cavity for observation.

However, if the pressure inside the body cavity becomes too high due to excessive air supply due to cleaning the objective lens surface or due to carelessness on the part of the operator, the inner wall of the body cavity will hyperextend, making it difficult to observe minute changes in the mucous membrane. This may not only make the patient unable to do so, but also cause discomfort to the patient, and in some cases may cause accidents such as damage to the inner wall of the body cavity. Furthermore, when performing endoscopic laser therapy, etc., air is generally continuously supplied into the body cavity, so there is a similar risk.

Therefore, in the past, a pressure detector was installed to detect the pressure in the suction line of the endoscope, the pressure inside the body cavity was detected through the suction line, and the suction device connected to the suction line was connected to the pressure detector. It was operated according to an output signal to perform suction for a certain period of time (for example, 0.5 seconds) to automatically reduce the intrabody cavity pressure.

[Problem that the invention seeks to solve]

As mentioned above, conventional endoscopic body cavity pressure adjustment devices simply operate suction for a certain period of time (0.5 seconds) to reduce the pressure when the body cavity pressure rises, regardless of the set pressure. When the set pressure is low, the pressure is reduced too much by one suction, and conversely, when the set pressure is high, the pressure reduction cannot keep up with one suction, creating an imbalance, and the stability of the body cavity pressure depends on the set pressure However, there were significantly different drawbacks.

This invention eliminates such conventional drawbacks and
It is an object of the present invention to provide a body cavity pressure adjusting device for an endoscope that can always keep the body cavity pressure stable and constant no matter what the set pressure is.

[Means for solving problems]

In order to solve the above-mentioned problems, the endoscopic body cavity pressure adjusting device according to the present invention has a suction channel 14 that opens into the insertion section 1 of the endoscope, as shown in FIG.
A suction means 15 connected in communication with the suction pipe 14, a pressure detection means 16 for detecting the pressure in the suction pipe 14, a pressure setting means for setting the body cavity internal pressure to be constant, and comparing the set pressure and the detected pressure. and a suction control means for outputting a signal for operating the suction means 15 for a certain period of time, and the suction control means is adapted to change the time for one operation of the suction means 15 in accordance with the set pressure. Features.

[Effect]

The pressure detection means detects the pressure within the suction line, and thereby the intra-body cavity pressure is detected via the suction line. On the other hand, the internal body cavity pressure to be kept constant is set by the body cavity internal pressure setting means, and the suction control means compares the set pressure and the detected pressure, operates the suction means for a certain period of time, and automatically maintains the body cavity internal pressure at the set pressure. It will be done. The duration of one operation of the suction means automatically changes depending on the set pressure.

〔Example〕

An embodiment of the present invention will be described based on the drawings.

1 is an insertion part of an endoscope inserted into a body cavity, 2 is an operation part, 3 is a connector connected to an external light source device 4, and inside the light source device 4 is an illumination lamp 5 and an air supply means 6. An air pump is provided.
Illumination light enters the illumination light guide 7 of the endoscope from the illumination lamp 5, and gas such as air is sent from the air supply means 6 to the air supply pipe line 8 inserted into the endoscope. The air supply conduit 8 passes from the connector 3 through the operating section 2 and the insertion section 1 and opens at the distal end of the insertion section, with a switching valve 9 protrudingly inserted into the operating section 2 in the middle.

This switching valve 9 is a known one, and a detailed explanation will be omitted, but normally, the air supply pipe line 8 is in communication with the outside air, and the air is sent from the air supply means 6 and released to the outside, and the switching valve 9 is opened. When pressed with a fingertip, the gap with the outside air is closed and air is supplied into the body cavity through the opening at the tip of the insertion section 1. Note that an electric switch or the like may be provided in place of such a switching valve, and the air supply means may be one that continuously supplies air or one that automatically controls the air supply operation. Good too.

Reference numeral 11 denotes a forceps channel through which a treatment instrument or the like is inserted, the distal end of which is open at the distal end of the insertion section 1, and the proximal end communicated with a forceps insertion port 12 formed at the lower part of the operating section 2. Reference numeral 14 denotes a suction tube made of, for example, polyurethane resin or silicone resin, and is removably connected to the forceps insertion port 12 of the endoscope via a connection mouthpiece 13 that is connected to the mouth of the suction tube. Reference numeral 10 designates a known forceps plug provided in the connection cap 13 and having a structure in which, for example, a slit is formed in a rubber plug, through which treatment tools can be inserted into the forceps channel 11, and the treatment tools can be inserted. It is sealed when not in use.

The suction tube 14 is connected to an external suction means 15, and the forceps channel 11 and the suction tube 14 form a suction channel that opens at the distal end of the insertion section 1. The suction means 15 includes a suction pump 15a, a suction tank 15b that stores the suction material,
It consists of first and second electromagnetic on-off valves 15c and 15d. The first electromagnetic on-off valve 15c is a normally closed type, and the second electromagnetic on-off valve 15d is a normally open type solenoid valve.The first electromagnetic on-off valve 15c is provided with an opening/closing frequency counter 34 that counts the number of openings and closings. ing. The first electromagnetic on-off valve 15c is interposed in the middle of the suction tube 14, and a ventilation pipe 15e is branched from a pipe line halfway between the first electromagnetic on-off valve 15c and the suction tank 15b and is open to the outside air. A second electromagnetic on-off valve 15d is interposed in the middle.

Therefore, in this embodiment, the suction pump 1
5a is operated at all times, and the first electromagnetic on-off valve 1
By closing the valve 5c and opening the second electromagnetic on-off valve 15d, outside air is sucked through the ventilation pipe 15e.
Conversely, while opening the first electromagnetic on-off valve 15c,
By closing the electromagnetic on-off valve 15e, suction is performed only from the suction tube 14, and in this way, the suction operation is controlled by the first and second electromagnetic on-off valves 15c and 15d interlocking.

A branch pipe line 14a is formed in communication with the suction tube 14, and a pressure detector 16 for detecting the pressure inside the suction tube 14 is connected to the branch pipe line 14a.
The pressure inside the body cavity is detected through the suction pipe (suction tube 14, forceps channel 11) and branch pipe 14a if each pipe is not blocked. A indicates a branch. Also,
A second air supply means 17 for supplying air into the suction tube 14 is provided in the middle of the branch pipe line 14a, close to the pressure detector 16. This second air supply means 17 is, for example, a small air supply pump, and a small amount (for example, 30 to
70ml) of air is supplied continuously or intermittently.

Further, a normally open third electromagnetic on-off valve 18 for opening and closing the pipe is provided near the branch A of the branch pipe 14a, and the electromagnetic on-off valve 18 and the pressure detector 16
A three-way electromagnetic on-off valve 19 for pipe switching is provided between the two. This three-way electromagnetic on-off valve 19 is connected to a water flow tube 21 that communicates with a water tank 20 storing cleaning water, etc., and by switching the three-way electromagnetic on-off valve 19, water is sucked through the branch pipe 14a. The pipe line 11 and the pressure detector 16 communicate with each other, or the suction pipe line 11 and the water passage tube 21 communicate with each other.

22 is a setting means for setting the intra-body cavity pressure desired by the operator, setting the mode of internal pressure adjustment, etc.;
pressure display means for displaying detected body cavity internal pressure, etc.;
24 is an alarm means that issues an alarm in the event of an abnormality;
These will be explained with reference to FIG. 3 showing the external appearance of the device.

In FIG. 3, reference numeral 22a is a pressure setting switch for setting the intra-body cavity pressure desired by the operator; pressing one of the two buttons increases the set pressure, and pressing the other button decreases the set pressure. Furthermore, this pressure switch 22
A foot-operated foot switch (not shown) may also be provided with a switch having the same function as a. The set pressure set here is displayed on the set pressure display 22b.

22c turns on the automatic adjustment function of body cavity pressure.
This is a switch that is turned OFF. When turned ON, the pressure inside the body cavity is automatically adjusted; when turned OFF, the pressure inside the body cavity is not automatically adjusted, and only the pressure detected by the pressure detector 16 is displayed. 22d is a suction mode setting switch that sets the suction time for one time to adjust the body cavity pressure, and the setting contents (low, auto, high) are displayed on the mode display lamp 22.
It is displayed on e. 22f is a three-way electromagnetic on-off valve 1
9 is a suction switch that selects the state of suction from the water tube 21. Setting means 22 is constituted by these switches 22a to 22f.

23a and 23b are pressure display means 23 for displaying the pressure detected by the pressure detector 16, 23a is a digital display for digital display, and 23b is a bar graph for analog display. 24a is a warning lamp, and this lamp 24
An alarm buzzer (not shown) that operates in conjunction with a is built into the device.

In FIG. 1, 25 is a microcomputer, which is composed of an input/output interface 25a, a central processing unit (CPU) 25b, and a memory 25c. The input terminal of the input/output interface 25a is connected to the output line of the setting means 22 and the A/D converter 2.
6, the output line of the pressure detector 16 and the output line of the opening/closing number counter 34 are connected. In addition, to the output terminal of the input/output interface 25a, each electromagnetic on-off valve 15c, 15d, 18, 19 is connected via drive circuits 27-30, and the air supply means 1 is connected via drive circuits 31-33.
7. Pressure display means 23 and alarm means 24 are connected.

Next, the operation of the above embodiment will be explained.

After inserting the insertion section 1 of the endoscope into the patient's body cavity, air is sent into the body cavity from the air supply means 6 in the light source device 4 by manually operating the switching valve 9 of the operation section 2. , the intrabody pressure increases.

In order to automatically control the internal pressure of the body cavity below an arbitrary set pressure, a connection cap 13 of an internal pressure adjusting device is connected to the forceps insertion port 12 of the endoscope. Even in this state, the treatment instrument can be inserted into the forceps channel 11 through the forceps plug 10 and used freely. Then, turn the automatic adjustment ON-OFF switch 22c.
Set it to ON and use the pressure setting switch 22a to set the pressure that is considered most appropriate for the test. The pressure is displayed on the set pressure display 22b.

In the normal state where the suction switch 22f is turned off, the first electromagnetic on-off valve 15c is closed, the second electromagnetic on-off valve 15d and the third electromagnetic on-off valve 18 are open, and the three-way electromagnetic on-off valve 19 is open. connects the branch pipe line 14a to the pressure detector 16. Therefore, the pressure detector 16 detects the intra-body cavity pressure via the suction tube 14 etc., and its output signal is converted into a digital signal via the A/D converter 26 and input to the input/output interface 25a. , the output signal from the input/output interface 25a is sent to the drive circuit 3.
2 to the display means 23 (digital display 23a
The bar graph 23b) displays the intra-body cavity pressure. The digital display 23a normally displays the detected pressure detected by the pressure detector 16 in real time, and the microcomputer 25
When the display is processed to prohibit interruptions, the immediately previous display state is maintained. Further, since the first electromagnetic on-off valve 15c is normally closed, the suction means 15 does not communicate with the suction tube 14 and only sucks atmospheric air through the ventilation pipe 15e. The second air supply means 17 supplies a small amount of air into the branch pipe 14a.

The CPU 25b compares the set pressure set by the setting means 22 and the detected pressure detected by the pressure detector 16, and when the detected pressure is higher than the set pressure, the output signal of the input/output interface 25a is displayed on the digital display. In addition to disabling the display of 23a and fixing it to the immediately previous display value,
The air supply from the second air supply means 17 is stopped, the second and third electromagnetic on-off valves 15d and 18 are closed, and the first electromagnetic on-off valve 15c is opened. After a certain period of time, everything returns to its normal state.

Therefore, during the certain period of time, the suction tube 14 communicates with the suction means 15, and the air in the body cavity is suctioned through the forceps channel 11 to reduce the pressure. A certain period of time during which this suction (depressurization) operation is performed is stored in the memory 25c of the microcomputer, and is controlled by an input signal from the suction mode setting switch 22d to the input/output interface 25a.
The suction operation time is different. In other words, when the suction mode is set to high mode, the pressure is reduced for 1 second, when it is set to low mode, the pressure is reduced for 0.2 seconds, and when the suction mode is set to auto mode, the set pressure is 10 mm.
0.3 seconds when the pressure is less than Hg, 0.5 seconds when the set pressure is between 10 mmHg and 15 mmHg, and 0.5 seconds when the set pressure is 15 mm
When Hg is exceeded, a decompression operation is performed for 0.7 seconds. In this way, the most appropriate mode can be selected depending on the circumstances of the endoscopy.

If the forceps channel 11 or the suction tube 14 is clogged with mucus, dirt, etc., the pressure detector 16 will no longer detect the pressure inside the body cavity. However, if the suction tube 14 etc. become clogged, the second air supply means 17
The pressure inside the tube increases due to a small amount of air discharged into the branch pipe 14a, so the pressure is detected by the pressure detector 16 and the above-mentioned suction (depressurization) operation is performed, causing the suction tube 14 to become clogged. The accumulated mucus and the like are suctioned and removed by the suction means 15.

However, as shown in FIG. 4, mucus, etc. accumulates in the downwardly bent portion of the suction tube 14, and the mucus cannot be removed from the bent portion of the tube with one suction (decompression) operation. Once this is completed, the mucus may return to the bottom of the bent part of the tube. In such a case, the pressure detector 16 will be at atmospheric pressure (0 mmHg) immediately after the suction operation is completed.
or lower pressure is detected. At that time, the input/output interface 25 of the microcomputer
In response to the output signal from a, the digital display 23a of the display means displays a display unrelated to the pressure value (for example, "EE"), indicating that the displayed value is not the intracavity pressure. Then, the suction operation is repeated due to an increase in the pressure inside the pipe due to the air supplied from the second air supply means 17, and while the suction operation is repeated three times, the pressure detector 1
When atmospheric pressure or lower pressure is continuously detected in step 6, the suction operation is performed continuously for a long time (for example, 1.5 seconds) according to the output signal from the input/output interface 25a of the microcomputer.
The clogged mucus etc. will be suctioned out. If the detected pressure exceeds atmospheric pressure, both the display and the suction operation time return to their normal state.

If too much air is being supplied into the body cavity and the suction operation of this device is not enough to reduce the pressure in time, an alarm will be issued. That is, when the pressure detected by the pressure detection means 16 exceeds a predetermined pressure (for example, 20 mmHg) a predetermined number of times (for example, three times) in succession, the alarm lamp 24a is turned on by an output signal from the input/output interface 25a of the microcomputer. At the same time, the alarm buzzer sounds. If the detected pressure falls below a predetermined pressure, the alarm will stop. Note that when the automatic adjustment switch 22c is OFF, the detected pressure is, for example, 2
An alarm is issued when a predetermined pressure is exceeded continuously for more than a second.

When cleaning the inside of the suction tube 14 and the branch pipe line 14a after the endoscopic examination, remove the connection cap 13 of the suction tube from the forceps insertion port 12 of the endoscope and place it in the cleaning liquid in the water tank 20. The tip of the water tube 21 is also placed in the cleaning liquid in the water tank 20. Then, when the suction switch 22f is turned on, the digital display 23a switches to a display such as "--" by the output from the input/output interface 25a, and the first and third electromagnetic on-off valves 15c, 18 are switched on. The second electromagnetic on-off valve 15 is opened.
d is closed. And 3-way electromagnetic on-off valve 19
However, for example, water is passed through tube 2 only twice at 0.5 second intervals.
1 side, and the suction tube 14 and the water passage tube 21 communicate with each other via the branch pipe 14a.
Then, since the suction tube 14 is longer than the water passage tube 21 and the resistance inside the pipe is greater, while the three-way electromagnetic on-off valve 19 is open to the water passage tube 21 side, there is no flow from the water passage tube 21 into the water tank 20. The cleaning liquid is sucked and the inside of the branch pipe 14a is cleaned.
When the water passage tube 21 side is closed, the cleaning liquid is sucked from the suction tube 14 and the inside of the suction tube 14 is cleaned.

Note that the suction tube 14 and the tubes near the electromagnetic on-off valves of the branch pipe 14a deteriorate due to repeated suction operations, that is, repeated opening and closing operations of the electromagnetic valves. It is now possible to notify by warning. That is, the output signal from the opening/closing frequency counter 34 is input to the input/output interface 25a of the microcomputer, and when the opening/closing operation of the first electromagnetic valve 15c reaches, for example, 200,000 times, the output signal from the input/output interface 25a is input to the input/output interface 25a of the microcomputer. The alarm lamp 24a is activated by the output signal of
lights up.

5 to 8 are flowcharts showing programs stored in the memory 25c of the microcomputer 25, and s in the figures indicates a step.

In Figures 5 to 7, the suction switch is OFF.
This is a program that is executed in the case of , and if the suction does not operate in the middle, it is executed on average about 1000 cycles per second.

First, in s1, the counters m, n and flag f are initialized, for example, m=2000, n=3, f=0
shall be. Next, in s2, the detected pressure P from the pressure detector
is read, the detected pressure is displayed on the bar graph in s3, and the display is permitted to be interrupted on the digital display in s4.

Then, in s5, the opening/closing frequency counter of the first electromagnetic on-off valve is read, and in s6, the number of opening/closing counters is determined to be the number of tube replacements (for example, 200,000 times).
If the number of tube replacements has been reached, the alarm lamp is lit in s7 and the process proceeds to s9. If the opening/closing number counter has not reached the number of tube replacements in s6, in s8, Turn off the warning lamp and proceed to s9.

Next, in s9, it is determined whether the detected pressure P exceeds 20 mmHg, and if it exceeds 20 mmHg, the excessive pressure detection counter m is set to m=m- in s10.
1, in s11, if m=0, in s12,
Turn on the alarm lamp and alarm buzzer and proceed to s15. If m=0 in s11, the process directly proceeds to s15. In addition, if the detected pressure does not exceed 20 mmHg in s9, the alarm lamp and alarm buzzer are turned off in s13, and in s14, the excessive pressure detection counter m and the excessive pressure detection counter flag f are set to the initial value (m = 2000). , f=0) and proceed to s15.

In s15, the status of the pressure setting switch and other switches is read, in s16 the status of the automatic adjustment switch is determined, and when automatic adjustment is OFF, the status of the automatic adjustment switch is read.
Return to When automatic adjustment is ON, it is determined in s17 whether the detected pressure P is below the set pressure _P0 , and if the detected pressure P is not below the set pressure _P0 ,
In s18, the display state of the digital display is disabled with interruptions prohibited, and in s19, the suction operation time is selected from the table stored in the memory (ROM) according to the states of the mode setting switch and pressure setting switch. do.

FIG. 9 shows the table, in which the suction time is given depending on the set pressure and set mode. In this table, in high mode, 1
seconds, low mode gives a constant suction time of 0.2 seconds, and auto mode, the set pressure is 10mmHg
0.3 seconds if it is less than 15mmHg, 0.7 seconds if it exceeds 15mmHg,
At 10-15 mmHg, a suction time of 0.5 seconds is given.

Next, in s20, the first to third electromagnetic on-off valves are set to the suction (pressure reduction) state. That is, the first electromagnetic on-off valve is opened, and the second and third electromagnetic on-off valves are closed. Then, in s21, subtract the suction operation time,
If the remaining suction operation time is not 0 in s22, s2
Returning to step 1, when the remaining suction operation time reaches 0 in s22, the first to third electromagnetic on-off valves are returned to the original normal state in s23, and the display interrupt prohibition on the digital display is released in s24. Proceed to s25.

In s25, flag f for excessive pressure detection counter
When f=0, the overpressure detection counter m is set to m=3 in s26, a flag is set (f=1) in s27, and the process proceeds to s28. In s17, when the detected pressure P is less than or equal to the set pressure _P0 , the process directly proceeds from s17 to s28.

In s28, the detected pressure P from the pressure detector is read, and in s29, it is determined whether the detected pressure P is 0 mmHg or less. When the detected pressure P is 0 mmHg or less, in s30, the display on the digital display is set to "EE" and the display state is locked, and in s31, the detection counter n is set to n=n-1.
If n=0 in s32, return to s2,
If n=0, the first to third electromagnetic on-off valves are switched to the suction (depressurization) state for 1.5 seconds in s33. Then, in s34, n is reset to n=3 and the process returns to s2. Further, if the detected pressure is not 0 mmHg or less in s29, n is reset to n=3 in s35, the display interrupt inhibition of the digital display is canceled in s36, and the process returns to s2.

FIG. 8 is a flowchart showing a program executed when the suction switch is ON. First, in s51, the counter i is initialized, and i=2.
shall be. Next, in s52, the display state of the digital display is set to, for example, "--" and the display state is locked.
At s53, the first to third electromagnetic on-off valves are brought into the suction state. Then, if i=0 in s54, s55
Then, open the 3-way solenoid on-off valve for 0.5 seconds to the water flow tube side to communicate the water flow tube and the suction tube, and when the 3-way solenoid on-off valve returns to its original state after 0.5 seconds, proceed to s56. Counter i = i-1
, wait 0.5 seconds in s57 and return to s54.
When i=0 in s54, the process directly proceeds to s57 and returns to s54 again.

FIG. 10 is a graph showing data obtained by measuring the state of body cavity pressure using the device of this embodiment in clinical practice.

A, B, and C in Figure 10 indicate the set pressure, respectively.
This shows the state of the body cavity pressure when it is set to 10, 15, and 20 mmHg, and both 2 and 5 show the state where the body cavity pressure increases momentarily due to burping. As can be seen from this data, the device of this embodiment can maintain the intra-body cavity pressure at a constant level extremely accurately during endoscopy.

〔Effect of the invention〕

According to the endoscope intracavity pressure adjustment device of the present invention,
Since the time for one operation of the suction means automatically changes depending on the set pressure, the amount of suction per operation of the suction means is adjusted to the optimal amount according to the set pressure, and the internal body cavity pressure is kept constant. Regardless of the height of
It has an excellent effect of keeping the intra-body cavity pressure stable and constant at all times.

[Brief explanation of drawings]

Figure 1 is a block diagram showing the configuration of the present invention, Figure 2 is a block diagram showing the configuration of the present invention.
The figure is a block diagram of an embodiment of the present invention, FIG. 3 is a perspective view of the external appearance of the device of the embodiment, FIG. 4 is a schematic external view of the suction tube in a state in which it is bent downward, and FIG.
8 through 8 are flowcharts showing programs stored in the memory of a microcomputer;
FIG. 9 is a chart showing a table similarly stored in the memory, and FIG. 10 is a graph showing the experimental results of measuring the state of adjustment of the body cavity pressure by the apparatus of the embodiment.

Claims (1)

[Claims] 1. A suction means connected in communication with a suction line opening into the insertion portion of the endoscope, a pressure detection means for detecting the pressure in the suction line, and a pressure setting means for setting the internal body cavity pressure to be constant. The suction control means compares the set pressure with the detected pressure and outputs a signal to operate the suction means for a certain period of time, and the suction control means operates one time of the suction means in accordance with the set pressure. An endoscopic body cavity pressure adjustment device characterized in that the time is changed.